Annual Public Meeting Bronx | NYC Health + Hospitals

Annual Public Meeting Bronx

Annual Public Meeting Bronx
Tuesday, May 19, 2015

Remarks by Ram Raju, MD
President, NYC Health and Hospitals Corporation

Good evening.

As President and CEO of the Health and Hospitals Corporation, I am glad to welcome you to tonight’s meeting. The Board and I deeply appreciate that you have taken time out of your busy lives to attend.

By showing up this evening, and at countless other meetings and events throughout the year, you are demonstrating a level of commitment to New York City’s public hospital system that makes it the nation’s largest and strongest.

One of the ways our City is unique is that New Yorkers have historically recognized the need for a public hospital system, because we understand that public hospitals are essential to keeping the City healthy and safe.

One need look no further than last October’s Ebola scare to illustrate this point. When the City was threatened, the Health and Hospitals Corporation was confident, ready, and prepared. We partnered with the Mayor’s Office, The Office of Emergency Management, the Department of Health and Mental Hygiene, and the State to step forward and safeguard the health of every New Yorker.

And that’s exactly what we did.

Our patient returned to good health.

The City was protected.

And the threat of epidemic and panic gave way to public understanding that forethought, training, and planning by public health officials had proven entirely effective.

That incident is just one recent example of why New Yorkers have historically supported a strong public hospitals system — — a system that combines top quality care with a commitment to serve every New Yorker in need.

The tremendous tie our hospitals, diagnostic treatment centers, and clinics have to the communities we serve across the city, remains the foundation of the Health and Hospitals Corporation’s strength, and its endurance.

However, the fact is, the Health and Hospitals Corporation needs your support more than ever before. That is because today’s healthcare landscape is undergoing great change. And these changes pose challenges to public hospitals systems across the country, and here in New York.

For example, the Affordable Care Act has made insurance available for many people who now for the first time, have options to seek care elsewhere if they choose.

And although the ACA reform does not extend health insurance coverage to undocumented New Yorkers, Federal funding for “Safety Net” hospitals is being reduced nonetheless.

At the same time major reforms to Medicare and Medicaid are driving big changes in the way we deliver health care to our patients, and in the way we are reimbursed by third party payers for services provided to patients.

In order to survive —- — In order to continue serving the nearly 1.4 million New Yorkers who seek our care each year, the Health and Hospitals Corporation is striving each and every day to meet these challenges.

We are committed to securing our essential role as New York City’s Public Hospitals system, and to ensuring that we continue fulfilling our mission of providing health care for all.

Last month we announced Vision 2020. This is an ambitious agenda which will position the Corporation more competitively, by building on transformational work done over the past two decades that produced outstanding quality and safety achievements.

Vision 2020 sets strategic priorities for achieving improved levels of patient satisfaction at each of our facilities. Vision 2020 also calls for expanding access to care, building our patient base, and securing the system’s financial stability all within the next 5 years.

Meeting each of these goals is necessary — — It’s necessary for the public hospital system to continue providing highest quality, cost-effective, culturally competent, and geographically convenient health care services to all New Yorkers.

In 2014, 313,764 New Yorkers accessed Health and Hospitals Corporation services at our Bronx facilities.

From Woodlawn to Mount Hope —
— from Hunts Point to Mott Haven—

The Public Hospital system has been here for residents of The Bronx for generation after generation.

We have been here for the city’s workforce which depends on our services disproportionately.

And we’ve been here for the tens of thousands of our employees who work at facilities across the city.

We’ve were here for the approximately 98,342 uninsured patients who accessed our care in the Bronx last year.

And I’m here to say tonight that we will absolutely continue to be here for the Bronx in the future.

And New Yorkers seeking care at our Bronx facilities can do so with confidence that our operations are stronger than ever.

Just earlier this month, Lincoln Hospital was awarded accreditation by the Joint Commission.

North Central Bronx Hospital received three year accreditation last year, as did Jacobi Medical Center in 2013.

But before we proceed with tonight’s meeting, let me quickly mention a few noteworthy transformational efforts at facilities here in the Bronx:

  • The North Bronx Healthcare Network reached a significant milestone last October with the resumption of Labor and Delivery services at North Central Bronx Hospital. The unit was closed in August of 2013 due to severe staff shortages. During the 14 month hiatus, a clear strategy for the clinical operation was developed.
    • Patient and baby safety is at its core, along with a staffing model that emphasizes the central role of midwives.
    • A talented, committed, and diverse group of senior physicians have been recruited.
    • And all members of the nursing staff have participated in major clinical training initiatives that have upgraded their skills.


    At the same time, the Labor & Delivery unit has received a $2 million modernization for physical upgrades and installation of new equipment and technology.
    Private labor and delivery rooms with updated furnishings create a more pleasant ambience for patients during their stay.
    Community input was an essential component to successfully reopening the Labor & Delivery unit. Your voices lead to strong City Council support, and ultimately, to a pivotal $600,000 allocation.
    Since re-opening nearly 500 babies have been delivered, including over 100 babies in March 2015.
    1400 women received pregnancy related medical services in the new unit as of last month. These metrics strongly indicate effective community outreach and the successful resumption of services that we can all be proud of.

  • Another important initiative of the North Bronx Health Care Network over the past year involves work to reduce the length of behavioral health hospital stays. Increasingly the psychiatric community nationwide has recognized the efficacy of treating behavioral health patients in the least restrictive environment that their situation allows.

    Over the past year, Jacobi and North Central Bronx Hospital have prioritized improving performance across the entire range of behavioral health procedures including:

    • Evidenced-based dosing of Medications
    • Expediting Family Meetings within 3 Days of Admission
    • Tracking Antipsychotics to optimize a patient’s medication regimen as efficiently as possible

    Strategic interventions like these are enabling us to reduce the amount of time patients spend in the hospital, while ensuring that they receive proactive and ongoing treatment. We also help them maintain bonds to family, community and the daily tasks of living that are critical components of their recovery.
    At Jacobi, behavioral health length-of-stay has been reduced from 27.1 days to 14.4 days last month.
    And at North Central Bronx Hospital, stays were reduced from 23.1 to 14.1 days.

  • Moving south, last year Lincoln Medical Center completed an extensive expansion and renovation project for its Emergency Department. The project expanded its dedicated children’s emergency unit, and the adult waiting areas. The psychiatric and mental health emergency unit and the women’s health area were updated and enhanced. The number of beds in the trauma center, and the number of chairs in the asthma patient unit were increased.
  • Over the coming year Lincoln will continue to transform its Ambulatory Care Services by improving access for primary care, specialty services, and emergency operations.
  • Lincoln’s Community Health Education and Outreach department continues to partner with Latin American consulates to reach underserved populations throughout the South Bronx. These initiatives include blood pressure screening, referrals for medical appointments to Lincoln and our other facilities, and facilitation with Metro Plus enrollments. Teams of trained public health educators provide the latest health care information on subjects such as hypertension, cholesterol, diabetes, basic nutrition, lead poisoning smoking cessation, family planning, HIV, cancer awareness and more.
  • At Lincoln and at other facilities across the City, we are achieving great results in asthma care because we don’t just treat this disease as purely a medical problem, we also treat it as an environmental and social issue. The Bronx Asthma Coalition’s Respirar program, based at Lincoln, exemplifies this approach. When a family comes to the Lincoln Emergency Department for pediatric asthma care, Respirar is contacted.

    After the patient’s discharge, the family is visited in the home by a Lincoln community health worker, who builds a relationship of trust with the family, identifies asthma triggers in the home, and assists in eliminating them.

    This is just the sort of hands-on, socially conscious, patient-centric approach that differentiates Health and Hospitals Corporation from other providers.
  • Promoting the benefits of breastfeeding is another key focus at Lincoln, and we are quite proud that it has become the first hospital in the Bronx to be designated “Baby-Friendly” as part of the global hospital initiative sponsored by the World Health Organization. The Baby-Friendly initiative encourages hospitals and birthing centers to offer an optimal level of care for breastfeeding mothers and their babies. It distinguishes birth facilities worldwide that offer mothers the information, confidence and skills needed to successfully initiate and continue breastfeeding their babies.

These initiatives, and many others we won’t have time to mention tonight, are indicative of progress and innovation happening every day at the Health and Hospitals Corporation’s facilities in the Bronx.

We will never stop seeking to improve our operations in order to raise the quality care we already provide, to an even higher level.

We are focused as never before on ensuring that our patient’s experience…experience of our care is our overarching priority in everything we do.

Better patient experience will lead to better patient retention, to a broader patient base, and to increased market share, all of which will result in financial sustainability.

These initiatives reflect our commitment to remain a strong, viable partner with the communities of the Bronx as we endeavor together to achieve population health and wellness for all New Yorkers.

I’m glad to have the opportunity tonight to bring them to your attention.

Thank you. I feel privileged to lead this Corporation and to be here this evening with all of you.

WE ALWAYS PUT PATIENTS FIRST